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血小板输注后的促炎作用:综述。

Pro-inflammatory effects after platelet transfusion: a review.

机构信息

Department of Transfusion Medicine, Huashan Hospital, Fudan University, Shanghai, China.

出版信息

Vox Sang. 2020 Jul;115(5):349-357. doi: 10.1111/vox.12879. Epub 2020 Apr 15.

Abstract

BACKGROUND AND OBJECTIVES

Platelet has been linked to thrombosis in several studies. Inflammation is closely intertwined with thrombosis and occurs consecutively; it is therefore conceivable that platelet transfusions perform an increasingly vital role in inflammation. As platelet transfusions have been a significant therapeutic approach in patients for decades, serious risks including viral transmission, bacterial sepsis and acute lung injury have been demonstrated by retrospective studies and randomized clinical trials. Recent data suggest associations among platelet transfusion and pro-inflammatory responses.

MATERIALS AND METHODS

A systematic review (from 2014 to 2019) on English literatures was conducted. Data on platelet transfusion-related reactions were abstracted. Preset inclusion and exclusion criteria were applied to identify all eligible articles.

RESULTS

All patients abstracted have received platelet transfusion. This new review focuses on recent 5-year advances (from 2014 to 2019) to have found that the platelet transfusion as pro-inflammatory process, concerning secretion of platelet microparticles and other inflammatory factors.

CONCLUSION

It can be hypothesized that the platelet microparticles or biological response modifier pathways might be innovative and therapeutic approaches to improving platelet transfusion and pretransfusion manipulations to reduce transfusion-related adverse reactions and therefore improve the efficacy and safety of this wide-employed therapy.

摘要

背景和目的

已有多项研究表明血小板与血栓形成有关。炎症与血栓形成密切相关且相继发生,因此可以想象血小板输注在炎症中发挥着越来越重要的作用。由于血小板输注已成为患者数十年的重要治疗方法,回顾性研究和随机临床试验已经证明了其存在严重风险,包括病毒传播、细菌性败血症和急性肺损伤。最近的数据表明血小板输注与促炎反应之间存在关联。

材料和方法

对 2014 年至 2019 年的英文文献进行了系统评价。提取了与血小板输注相关反应的数据。应用预设的纳入和排除标准,以确定所有合格的文章。

结果

所有被提取的患者都接受了血小板输注。本次新的综述重点关注最近 5 年来(2014 年至 2019 年)的进展,发现血小板输注是一种促炎过程,涉及血小板微粒和其他炎症因子的分泌。

结论

可以假设血小板微粒或生物反应调节剂途径可能是改善血小板输注和输注前处理的创新和治疗方法,以减少与输血相关的不良反应,从而提高这种广泛应用的治疗方法的疗效和安全性。

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